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Developmental impairments following severe falciparum malaria in children

Julie A Carter1, Amanda J Ross, Brian G R Neville

  • 1Neurosciences Unit, Institute of Child Health, London, UK. j.carter@ich.ucl.ac.uk

Tropical Medicine & International Health : TM & IH
|January 19, 2005
PubMed

Insights

Children with cerebral malaria (CM) and malaria with complicated seizures (M/S) face long-term neurocognitive deficits. Active epilepsy in children with severe malaria history significantly increases risks for cognitive and behavioral issues.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neurodevelopmental Disorders

Background:

  • Cerebral malaria (CM) and malaria with complicated seizures (M/S) are known to cause neurological deficits in children.
  • However, the long-term neurocognitive consequences and developmental impairments following these conditions, particularly M/S, remain poorly understood.

Purpose of the Study:

  • To investigate the long-term developmental outcomes in children with a history of CM.
  • To assess the prevalence and characteristics of neurocognitive impairments in children with a history of M/S.

Main Methods:

  • A cohort study followed children aged 6-9 years with prior exposure to CM, M/S, and an unexposed control group.
  • Neurocognitive, motor, speech, language, hearing, and vision assessments were conducted.
  • Parental questionnaires identified children with epilepsy.

Main Results:

  • Children with CM showed significantly lower scores in higher-level language, vocabulary, pragmatics, and non-verbal functioning compared to unexposed children.
  • Children with M/S exhibited reduced functioning in phonology, pragmatics, and behavior.
  • Children with active epilepsy experienced poorer performance across comprehension, syntax, pragmatics, word finding, memory, attention, behavior, and motor skills.

Conclusions:

  • CM and M/S are associated with significant, persistent developmental impairments in children.
  • These findings have implications for an estimated 250,000 children annually in Sub-Saharan Africa.
  • Active epilepsy exacerbates cognitive and behavioral problems in children with a history of severe malaria.
Abstract

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